Drug interactions
Empagliflozin-metformin + Tolbutamide
Severity: Moderate
Empagliflozin-metformin and Tolbutamide: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Combining an SGLT2 inhibitor and metformin with a sulfonylurea such as tolbutamide increases the risk of hypoglycemia. The glucose-lowering effects are additive.
What this interaction means in plain words
Empagliflozin-metformin and Tolbutamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Empagliflozin-metformin belongs to Endocrine; Tolbutamide belongs to Endocrine.
Why it happens
Additive pharmacodynamic glucose lowering from sulfonylurea-driven insulin secretion plus glycosuria and reduced hepatic glucose output.
What to do
Consider reducing the tolbutamide dose when starting this combination, and monitor blood glucose. Educate the patient on hypoglycemia symptoms and management.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Empagliflozin-metformin
Other interactions of Tolbutamide
- Glyburide-metformin + Tolbutamide Major
- Insulin degludec-liraglutide + Tolbutamide Major
- Aceclofenac + Tolbutamide Moderate
- Acemetacin + Tolbutamide Moderate
- Acetylsalicylic acid + Tolbutamide Moderate
- Albiglutide + Tolbutamide Moderate
Frequently asked questions
Can I take Empagliflozin-metformin with Tolbutamide?
MediHelp rates the interaction as moderate. Empagliflozin-metformin and Tolbutamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Combining an SGLT2 inhibitor and metformin with a sulfonylurea such as tolbutamide increases the risk of hypoglycemia. The glucose-lowering effects are additive.
How serious is the interaction between Empagliflozin-metformin and Tolbutamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider reducing the tolbutamide dose when starting this combination, and monitor blood glucose. Educate the patient on hypoglycemia symptoms and management.
What other medicines interact with Empagliflozin-metformin?
MediHelp also lists interactions of Empagliflozin-metformin with, for example, Contrast media, Diatrizoate meglumine / diatrizoate, Diatrizoate. The full list is on the Empagliflozin-metformin page.
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